Tianeptine is an atypical tricyclic antidepressant that is prescribed mainly for the treatment of depression and anxiety disorder. There have been scattered reported cases of tianeptine dependence and abuse in the literature. We report the case of a 32-year-old gentleman with resistant major depressive disorder that was initially successfully treated with Tianeptine. When his depression relapse due to work-related issue, he step-up his dosages without supervision. He developed tolerance and withdrawal to tianeptine making it difficult for him to stop without help. This case highlights the possibility of tianeptine abuse to its high tolerability and easy access for purchase.
Substance abuse is an epidemic that spreads among adults, adolescents and even children in Malaysia. Substance abuse is categorized as a mental disorder, whereby, Cognitive Behavioural Therapy (CBT) is an approach that provides face to face physiological therapy for patients could resolve this issue. Computerized Cognitive Behavioural Therapy (CCBT) is a progression of information technology that is provided for patients encounter substance abuse. CCBT is a computerized therapy conducted at patient’s own pace. Ensuring patient’s continuous engagement towards CCBT becomes an issue. Patients that experience early gains, loss of interest and improvement symptom would sign up for alternative services that eventually causes disengagement and dropout from CCBT program. Interface design for CCBT is known as one of the important elements that effects patient’s engagement along CCBT program. Therefore, in this study, influential factors regarding CCBT’s interface design was investigated, whereby, five prominent models was reviewed. Content analysis methodology was employed to discover influential factors regarding CCBT’s interface design. Four influential factors was discovered namely engagement, dropout, culture and interface. These factors are known to ensure patient’s continuous engagement towards CCBT program. CCBT’s interface design plays a vital role in delivering the therapy program. Indirectly, CCBT’s interface design plays an important role to ensure patient’s continuous engagement till the completion of CCBT program. Therefore, these factors would guide researcher, service provider, developers and clinicians in designing engaging interface for CCBT.
Objectives: The objective of the study is to determine the prevalence of substance abuse for alcohol, cannabis, opiates, stimulants, solvent and other substances among patients with schizophrenia in Hospital Bahagia Ulu Kinta (HBUK), Perak , Central Peninsular of Malaysia. This study also aims to determine the association of substance abuse with aggression, the demographic characteristics and total duration of hospitalization.
Methods: This was a retrospective cross-sectional study whereby the first 194 subjects diagnosed to have schizophrenia based on International Classification of Disease, 10th edition (ICD-10) criteria were taken from data registry of patients admitted to HBUK from January until February 2004. The subjects’ medical files were examined for documentation of substances abuse, aggression and accumulative duration of hospitalization.
Results: The results showed the prevalence of substances misuse among patients with schizophrenia in general (including alcohol) was 24.7%. Cannabis 16.7%, alcohol 13.4%, opiates(heroin) 6.7%, Amphetamine type stimulants (amphetamine, metamphetamine, ecstacy) 5.7%, and other substances (benzodiazepine, solvents) 1.5%.
Conclusion: There is higher prevalence of substance misuse in patients with schizophrenia as compared to general population. Male patients with history of substance misuse are more likely to have aggression than female. This group needs special precaution and probably in need of specialist help.
This study aims to describe the pattern of sexual behaviour among methamphetamine and heroin users. It describes the pattern of sexual behaviour based on aspects of sex such as desire, interest, drive and obsession in relation to the drug use. A cross-sectional study was carried out among attendees of drug rehabilitation programmes in Kota Kinabalu, Kota Bharu and Kuala Lumpur. All subjects were living in the community with satisfactory psychosocial functioning. This study was primarily based on a validated sexual behaviour self-rated questionnaire followed by face-to-face interview. A total of 227 subjects were included with 124 (54.6%) using methamphetamine while 103 (45.4%) using heroin. Majority (218; 96%) were heterosexuals with 104 (45.8%) reported having been involved in high risk sexual behaviour. More methamphetamine than heroin subjects agreed that their sexual thoughts, feelings and behaviours were often associated with the drug (p<0.05). Methamphetamine subjects agreed that the use of methamphetamine caused them to be more obsessed with sex and they found themselves to be preoccupied with sexual thoughts while being under the influence of the drug (p<0.05). Heroin subjects mainly reported on negative effects of the drug on their sexual behaviour. Methamphetamine subjects reported that the use of drug had positively affected their sexual interest and drive (p<0.05). Methamphetamine subjects were also 1.97 times more likely than heroin subjects to be involved in risky sexual behaviour. The results of this study can be utilized to improve the drug treatment and rehabilitation programme. Methamphetamine subjects were more likely than heroin subjects to be involved in risky sexual behaviour.